| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
874 |
769 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
758 |
685 |
$73K |
| V2020 |
Frames, purchases |
1,820 |
1,339 |
$24K |
| 92015 |
Determination of refractive state |
1,963 |
1,770 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,728 |
1,251 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,237 |
908 |
$1K |
| 92310 |
|
34 |
26 |
$105.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
183 |
125 |
$81.99 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
88 |
65 |
$0.00 |